“Don’t Starve” is one recent game that encourages players to appreciate the real consequence of death. Image: Klei Entertainment
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What can “permadeath” video games teach us about suicide?

Permanence and finality in video games can help us be better at understanding, and talking about, mental health issues.

“Happy, depressed, spiteful, manic or suicidal? More Mudokons... with real emotions,” reads the back cover of the 1998 PlayStation video game Oddworld: Abe’s Exoddus.

To the credit of developers Oddworld Inhabitants, its titular Oddworld series was revolutionary in its exploration of mature themes – slavery, captivity, capitalist greed, to name but a few examples – which in the Nineties was a distinguished side-step from the whimsical cartoon mascots and fluorescent fantasy worlds prevalent at the time. Oddworld was darker and thus more intriguing than most of the competition, yet how Exoddus scrutinises suicide in this instance appears to resign the deeply complex state of mind to a badge of honour, a commodity, a testament to the game’s advanced artificial intelligence. Unfortunately, this blasé characterisation of the act is a damaging indictment of a game capable of tackling sophisticated ideas.

But again, Oddworld was ahead of its time. The fact that it even considered suicide within its narrative was against the grain. Nowadays, video games are more culturally aware and the burgeoning indie renaissance the medium has enjoyed over the last few years has facilitated a more refined discourse in and around interpersonal themes, not least suicide. Zoe Quinn’s Depression Quest and Will O’Neill’s Actual Sunlight both examine mental health by placing the player in the shoes of characters suffering from depression and suicidal tendencies. It’s bleak, but naturally reflects the subject matter. Most importantly, though, it’s informative – not only for those naive or ignorant to these conditions, but for those who may be in a relatable position, although the latter should be exercised with caution. Video games can never replace professional consultation, but they can show players that they’re not alone, and this can mark the first step towards remedial treatment.   

The rise of permadeath in video games – whereby player characters die permanently in-game, or where a game must restart from the beginning should the player character die, in the absence of multiple lives or continues – has changed the way players approach games. In these instances, emotion is often the driving force when it comes to decision-making, and thus with permadeath mental state governs player action, as opposed to logical rationale.

It’s worth noting here that self-sacrifice – when players kill themselves to respawn or restart levels; or non-playable characters sacrifice themselves for the greater good/to save their companions – is different from suicide as portrayed in the above examples. Permadeath essentially forces players to consider consequence, permanence and finality within the bounds of digital landscapes.

But what about out with virtual settings – are these themes and ideas transferable to reality? An academic paper published in 2014 entitled “Being Bad in a Video Game Can Make Us More Morally Sensitive”, co-authored by Dr Matthew Grizzard, discusses how engaging in certain virtual behaviours has scope to elicit feelings of guilt and can thus encourage prosocial real life consequences. Grizzard et al hypothesise that committing immoral behaviour in video games can lead to increased moral sensitivity in players. This would suggest a heightened sense or understanding of consequence on the part of the player, therefore I ask Dr Grizzard if this line of thought could extend to a better comprehension of suicide – both in-game and in real life.

“I think [the] question really has two parts: (1) Do video games encourage a better understanding of the finality of suicide in real life? Versus, (2) Could video games encourage a better understanding of the finality of suicide in real life?” he says. “With regard to the first question, I don’t think games necessarily encourage ideas of permanence and finality. Video games are designed to be played multiple times with death being a temporary inconvenience rather than permanent. In fact, players will sometimes even kill themselves in games when they encounter obstacles or become stuck in a game to ‘respawn’ at an earlier time point in the game. So video games, particularly popular press video games, encourage a view that death as temporary. Death is portrayed as detrimental in games, but it is not a one-way door.

“With regard to the second question – I do think games could encourage a better understanding of the finality of suicide.”

For many players, video games represent a safe place and facilitate a certain level of escapism. Reality is suspended and thus the in-game cycle of dying and respawning and restarting is part of the deal. But even in games that utilize the permadeath feature, death is often more of a hindrance than it is absolutely final, as Grizzard suggests. The games that use permadeath as their primary mechanic, such as Klei Entertainment’s 2013 hit Don’t Starve, seem to be the ones which best represent finality, encouraging players to appreciate the real consequence of death.

“As designers we work really hard to give players agency,” says Klei Entertainment founder Jamie Cheng. “Permadeath is almost ‘free’ agency, in that suddenly every action matters a whole lot more. I think players appreciate that, and as a designer it gives us a chance to show them similar scenarios over time, and how their actions can drastically change outcomes.

“Obviously emotion plays a part, but in my experience the emotion happens after the finality, not before. That is: when the player dies or a catastrophic event happens, that’s when the weight of consequence hits – but beforehand, players are simply more attuned to their actions and less frivolous.”

Although Cheng admits suicide was never something that was considered during Don’t Starve’s design process, he does point to the fact that it’s more important to consider the active adventure, as opposed to its end. I suggest that in a game which places so much emphasis on preserving life, comparisons between virtual and actual reality are more or less likely to follow.

“I’m unclear that there’s much correlation between in-game and reality,” offers Cheng. “Instead of affecting how players perceive reality, our goal is the other way around – to have a video game that mimics reality in its finality and consequence. In addition, we want players to enjoy the journey. Since the player knows that eventually they’ll lose it all, it makes more sense that the process is the interesting part, and not what you get at the end of the journey.”

It could be argued that no matter which way around these ideas are depicted, in light of what Cheng says, the end result illustrates an intrinsic link between game worlds and the real world. This would seem to play perfectly into Grizzard’s view that video games could do more in encouraging a better understanding of the finality of suicide. He points to other transformative media that tackles similar themes such as film, noting Frank Capra’s It’s a Wonderful Life as a pertinent example of how powerful viewing the world through someone else’s eyes – in this example a fictitious character – can be for viewers. There’s no reason why video games can’t deliver something similar.

“Evolutionarily, play represents a safe place to practice or experience skills that we generally don’t or can’t have direct access to in the real-world for many reasons,” adds Grizzard. “Both predatory and prey animals play to learn how to survive in the wild. Human play serves similar roles, with the skills that we learn being not only related to physical attributes but also social attributes. For example, in medical schools in the US, doctors-in-training practice giving bad news to patients in ‘play’ scenarios with actors.

“These scenarios help doctors practise skills that they rarely have the opportunity to practice in the real-world in a safe environment where making mistakes has few consequences. Video games can be particularly adept at allowing the same type of play for several reasons. Primarily, the human brain doesn’t firmly distinguish between real versus mediated stimuli. Our brain reacts to mediated images in a similar fashion as it does to real images. This is why scary movies can make us jump or tearjerkers can make us cry. Video games have the potential to provide players with a rich virtual environment filled characters and stimuli that they respond to as if they were real.

“As such, games could provide a glimpse into the severe negative consequences of suicide on family members and friends. This glimpse is obviously impossible in the real world, but games have the ability to simulate it.”

Video games are in the auspicious position of not only being a persuasive, cogent and expressive medium, but, unique to any other form of media, are also interactive. Physically engaging players in two-way stories arguably puts the platform in the best position to challenge perceptions, and to explore personal, more sophisticated themes. In the grand scheme of things, video games as a medium are relatively new, thus there is no reason why this can’t or won’t continue to grow in the future.   

“Video games do have the potential,” adds Grizzard. “However, questions still remain as to whether a single play experience that associates strong consequences with suicide could overcome the more traditional ‘death is temporary’ play experiences that are generally seen in video games. These are fascinating questions, and I would be hesitant to conclude one way or the other. “As always, more research must be done.”

Research such as Grizzard’s, coupled with the rising number of video games tackling social issues, must continue. As a society, suicide has become stigmatised to the point where we seem almost scared to discuss the subject for fear of admitting failure or weakness. This is, of course, ridiculous and British culture is particularly guilty of endorsing the “stiff-upper lip” mentality that perpetuates warped machismo doctrines such as this. I’m from Glasgow and in 2012, the suicide rates in Scotland were 73 per cent greater than those of England and Wales. No one is suggesting video games can single-handed drive these statistics down, but if the medium can help encourage healthier, more enlightened conversation around the issue, then it's heading in the right direction.

If you are affected by any of the issues discussed here, you can call the Samaritans free in the UK on 08457 909090, or in the US contact the National Suicide Prevention Line on 1-800-273-8255.

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The NS Q&A: Naomi Alderman on Oprah, Ovid, and Buffy The Vampire Slayer

"The worst things that ever happened to me were before I was 20."

What’s your earliest memory?

Sitting on a striped blue-and-white deckchair with a migraine. My mother gave me orange squash. We’ve worked out (from the deckchair) that I was 18 months old.

Who was your childhood hero?

I was incredibly inspired by Oprah Winfrey as a young woman. Her childhood (sexual and physical abuse, teenage pregnancy, the death of her baby) was traumatic, and her subsequent life has been defined by hard work, talent and one glorious victory after another. People in the UK can sneer about her because we are terrified of emotions and she’s not perfect (who is?), but she introduced me to the possibility of improving one’s internal life. A miracle.

What was the last book that made you envy the writer?

Francis Spufford’s Golden Hill. It’s as if he managed to voyage back a few hundred years and just take notes.

What political figure, past or present, do you look up to?

Florence Nightingale, who was a terrible nurse but a brilliant statistician and wielded her public image to influence politicians to improve health care. I wish that she were still around, skewering ministers misusing statistics on Question Time.

When were you happiest?

Now. The worst things that ever happened to me were before I was 20. It has been slow, hard-won improvement since then.

What would be your Mastermind special subject?

Buffy the Vampire Slayer, or Ovid. Both are intensely serious, as well as funny. Both wield myths to talk about their modern world. Both are subjects I’d like to revise.

Which time and place, other than your own, would you like to live in?

The future. As far as possible. Not to live, though – just to visit.

Who would paint your portrait?

I’d like [the 16th-century Dutch painter] Jan van Scorel, please, with the same affection and knowingness as his portrait of Agatha van Schoonhoven. They lived together and had six children, even though he was a canon and couldn’t marry.

What’s your theme tune?

A Jewish song that goes: “Lo alecha hamlacha ligmor . . .” It translates as: “It’s not up to you to finish the work, but neither are you free to refrain from it.”

What’s the best piece of advice you’ve ever received? And have you followed it?

I know how this sounds, but my deceased grandmother appeared to me in a dream once and told me something I can’t share. But I did follow her advice and it was excellent. (Thanks, Booba and/or my subconscious.)

What’s currently bugging you?

Brexit. I want to start a campaign called “Back in 30” – to get us back into the EU by 2030, when Remainers (or Rejoiners) will almost certainly be a convincing majority.

What single thing would make your life better?

I wish that Gordon Brown had called a snap election in 2007.

If you weren’t a writer, what would you be?

I think I would have enjoyed running a business (and I sort of do run one now, with the video games). I’ve got the brain for systems and a head for figures. But all these daydreams end with: “And I could carve out time to write.”

Are we all doomed?

No. The species will continue, whatever apocalypse we manage to unleash. It just won’t be much fun to live through.

Naomi Alderman’s novel “The Power” (Penguin) is shortlisted for the Baileys Prize

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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